Hospital tuning up inner workings

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Eureka Springs Hospital Treasurer Barbara Dicks told commissioners on Monday the total cash assets are $1.64 million with only one expense of $90 for adding a lock to a file cabinet that houses commissioner documents. “The hospital is paying our bills now,” Dicks said, indicating the commission’s initial operational cash outlay given to the hospital for everyday business expenses during the transitional ownership was not required in June.

“We have gone three months without having to give them any money,” Chair John House said.

Commissioners received a verbal cash flow snapshot showing a checking account balance of about $2 million.

Transactions under the microscope

Darrell Parke of Alliance Management noted at Monday’s Hospital meeting that CPA Scott Stone and staff are working on the general ledger cleanup of thousands of transactions in order to close out previous months. Parke said accounts have not been accurately posted for a very long time. “It’s a mess,” he said, “it’s a vast and deep hole.”

However, after the G.L. cleanup is complete, Parke said the interim cost report can be completed.

Once the cost report is completed it must be sent to Medicare, and Mark Stearns of Alliance said the hospital must wait for Medicare to approve before final financial projections can be made. Stearns said that Medicare has been helpful through the ownership transition but said he has no idea how long their approval of the cost report may take. Parke also said the hospital’s charge master is under construction and staff is auditing each line item to make corrections for accurate coding and billing processing.

ER visits down, supplies needed to help with Covid

In the matter of utilization of the emergency room, Parke said it is being under-utilized. “We are not seeing the typical volume or mix that history tells us we should have for this time of year,” he said. Currently, the hospital is realizing about 200 visits per month where he said it normally is closer to 350 visits. “Because of Covid we are seeing fewer patients,” Parke said.

Commissioners discussed the possibility of accepting hospital overflow from Northwest Arkansas to boost revenue.  Parke said he is working with the Hospitalist Dr. Daidone to analyze this option saying, “The only issue is the supply issue.”

Parke said that a rural hospital must be able to maintain supplies and pharmacology required to support an influx of Covid patients. “Currently we are required to provide daily reporting to state and federal authorities regarding the number of patients seen, positive patients, pharmacy usage, supplies, and so forth,” Parke said. If the issue of supply is resolved, he said “We can treat these patients — we have treated these patients — we’ve been successful.”

Parke said the hospital has performed about 30 Covid tests, with very few positive results. “This side of the county seems to be doing very well,” Parke said. “We are starting to see more people wanting to be tested.” Chair House stated that Washington Regional is reaching its capacity saying, “Yeah, it definitely is full.”

ESH unable to rent or buy analyzer due to history

In May the commission approved the medical equipment lease of the “gold standard” of Covid testing, the Cepheid GeneXpert analyzer system that provides accurate diagnostic tests for coronaviruses and is considered superior to the Abbott Analyzer the hospital is currently utilizing. Because the Abbott Analyzer is known to produce false negative results, the hospital is still sending tests out of state for precise lab results, a process that can take up to two weeks depending on the priority status.

Monday night Parke informed the commission that the hospital has been unable to lease the requested GeneXpert saying, “We were rejected on our lease.” As Parke described the situation saying, “Our history as a hospital over the last few years has caused problems with both the purchase and the lease. It’s our history — it’s nothing we’ve done currently,” Parke assured commissioners.

The company selling the GeneXpert refused the $1,000 monthly lease to the hospital, and also refused an outright purchase price of $65,000.  “So, they don’t want our money,” Baranyk responded. House responded, “My guess is that they’re not hurting for any money right now.”

House said there is a lot of movement happening at the hospital and extended gratitude to Parke and Stearns for their management services saying, “I am so grateful for the work you are doing.” House said a year ago the commission was asking itself how it was going to keep the hospital open. Now the hospital’s operations checking account has more money than the entire cash reserve.      

The next regular meeting is scheduled for Monday, August 17 at 6 p.m. 

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